Revista Brasileira De Reumatologia最新文献

Introduction

To date, there are no descriptions in the literature on gynecologic and sexual function evaluation in female patients with dermatomyositis (DM) and polymyositis (PM).

Objective

To assess sexual function in female patients with DM/PM.

Patients and methods

This is a monocentric, cross‐sectional study in which 23 patients (16 DM and 7 PM), with ages between 18 and 40 years, were compared to 23 healthy women of the same age group. Characteristics on sexual function were obtained by applying the questionnaires Female Sexual Quotient (FSQ) and Female Sexual Function Index (FSFI) validated for the Brazilian Portuguese language.

Results

The mean age of patients was comparable to controls (32.7 ± 5.3 vs. 31.7 ± 6.7 years), as well as the distribution of ethnicity and socioeconomic class. As for gynecological characteristics, patients and healthy controls did not differ with respect to age at menarche and percentages of dysmenorrhea, menorrhagia, premenstrual syndrome, pain at mid‐cycle, mucocervical secretion, and vaginal discharge. The FSQ score, as well as all domains of the FSFI questionnaire (desire, arousal, lubrication, orgasm and satisfaction), were significantly decreased in patients versus controls, with 60.9% of patients showing some degree of sexual dysfunction.

Conclusions

This was the first study to identify sexual dysfunction in patients with DM/PM. Therefore, a multidisciplinary approach is essential for patients with idiopathic inflammatory myopathies, in order to provide prevention and care for their sexual life, providing a better quality of life, both for patients and their partners.

Objective

The aim of this study was to investigate the effectiveness of Kinesio Taping and sham Kinesio Taping on pain, pressure pain treshold, cervical range of motion, and disability in cervical myofascial pain syndrome patients (MPS).

Methods

This study was designed as a randomized, double‐blind placebo controlled study. Sixty one patients with MPS were randomly assigned into two groups. Group 1 (n = 31) were treated with Kinesio Taping and group 2 (n = 30) were treated sham taping five times by intervals of 3 days for 15 days. Additionally, all patients were given neck exercise program. Patients were evaluated according to pain, pressure pain treshold, cervical range of motion and disability. Pain was assessed by using Visual Analog Scale, pressure pain treshold was measured by using an algometer, and active cervical range of motion was measured by using goniometry. Disability was assessed with the neck pain disability index disability. Measurements were taken before and after the treatment.

Results

At the end of the therapy, there were statistically significant improvements on pain, pressure pain treshold, cervical range of motion, and disability (p < 0.05) in both groups. Also there was a statistical difference between the groups regarding pain, pressure pain treshold, cervical flexion‐extension (p < 0.05); except cervical rotation, cervical lateral flexion and disability(p > 0.05).

Conclusion

This study shows that Kinesio Taping leads to improvements on pain, pressure pain treshold and cervical range of motion, but not disability in short time. Therefore, Kinesio Taping can be used as an alternative therapy method in the treatment of patients with MPS.

Osteoarthritis (OA) is the most common form of arthritis and is frequently diagnosed and managed in primary care; it is characterized by loss of articular hyaline cartilage, which is a unique connective tissue that physiologically lacks blood vessels. Articular cartilage survives in a microenvironment devoid of oxygen, which is regulated by hypoxia inducible factor (HIF‐1α). HIF‐1α is considered the main transcriptional regulator of cellular and developmental response to hypoxia. To date, the relevance of HIF‐1α in the assessment of cartilage has increased since its participation is essential in the homeostasis of this tissue. Taking into account the new emerging insights of HIF‐1α in the scientific literature in the last years, we focused the present review on the potential role of HIF‐1α signaling pathway in OA development, especially in how some genetic factors may influence the maintenance or breakdown of articular cartilage.

Aim

To investigate the relation between vascular endothelial growth factor (VEGF) gene polymorphism in systemic lupus erythematosus (SLE) patients and lupus related neuropsychiatric manifestations.

Patients and methods

Sixty adult SLE patients recruited from the Rheumatology and Neurology departments of Cairo University hospitals were classified into two groups; Group A: 30 patients with neuropsychiatric manifestations (NPSLE) and Group B: 30 patients without. For both groups the SNP G1612A (rs10434) of the VEGF gene was genotyped by real time polymerase chain reaction (RT‐PCR).

Results

Statistically significant difference was found in genotype and allele frequencies between both groups (AA [70% vs 13.3%, p < 0.001] and GG [10% vs 66.7%, p < 0.001]).

Conclusion

Polymorphism in the gene coding for VEGF may be associated with increased incidence of neuropsychiatric lupus in SLE patients.

Objective

To describe the performance of a non‐fluoroscopic fixed‐flexion PA radiographic protocol with a new positioning device, developed for the assessment of knee osteoarthritis (OA) in ELSA‐Brasil MSK.

Material and methods

A test‐retest design including 19 adults (38 knee images) was conducted. Feasibility of the radiographic protocol was assessed by image quality parameters and presence of radioanatomic alignment according to intermargin distance (IMD) values. Repeatability was assessed for IMD and joint space width (JSW) measured at three different locations.

Results

Approximately 90% of knee images presented excellent quality. Frequencies of nearly perfect radioanatomic alignment (IMD ≤1 mm) ranged from 29% to 50%, and satisfactory alignment was found in up to 71% and 76% of the images (IMD ≤1.5 mm and ≤1.7 mm, respectively). Repeatability analyses yielded the following results: IMD [SD of mean difference = 1.08; coefficient of variation (%CV) = 54.68%; intraclass correlation coefficient (ICC) (95%CI) = 0.59 (0.34‐0.77)]; JSW [SD of mean difference = 0.34 ‐ 0.61; %CV = 4.48% ‐ 9.80%; ICC (95%CI) = 0.74 (0.55‐0.85) ‐ 0.94 (0.87‐0.97)]. Adequately reproducible measurements of IMD and JSW were found in 68% and 87% of the images, respectively.

Conclusions

Despite the difficulty in achieving consistent radioanatomic alignment between subsequent radiographs in terms of IMD, the protocol produced highly repeatable JSW measurements when these were taken at midpoint and 10 mm from the medial extremity of the medial tibial plateu. Therefore, measurements of JSW at these locations can be considered adequate for the assessment of knee OA in ELSA‐Brasil MSK.

Juvenile rheumatic diseases affect the musculoskeletal system and begin before the age of 18. These conditions have varied, identifiable or unknown etiologies, but those of an autoimmune inflammatory nature have been associated with an increased risk of development of cancer, regardless of treatment. This study aims to assess, through a systematic review of the literature according to Prisma (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) quality criteria, the risk of cancer in patients with juvenile rheumatic disease, and its association with biological agents. The criteria described by the Strengthening the Reporting of Observational Studies in Epidemiology initiative were used in order to assess the methodological quality of those individual items selected in this study. We analyzed nine publications, from a total of 251 papers initially selected. There was an increase in cancer risk in the population with juvenile rheumatic disease versus the general population. Most specified cancers were of a lymphoproliferative nature. Seven studies did not specify the treatment or not defined an association between treatment and cancer risk. Only one study has suggested this association; in it, their authors observed high risk in patients diagnosed in the last 20 years, a period of the advent of new therapies. One study found an increased risk in a population not treated with biological agents, suggesting a disease in its natural course, and not an adverse effect of therapy. Studies have shown an increased risk of malignancy associated with juvenile rheumatic disease, and this may be related to disease activity and not specifically to the treatment with biological agents.

Rheumatoid arthritis (RA) is a well and widely recognised cause of carpal tunnel syndrome (CTS). In the rheumatoid wrist, synovial expansion, joint erosions and ligamentous laxity result in compression of the median nerve due to increased intracarpal pressure. We evaluated the published studies to determine the prevalence of CTS and the characteristics of the median nerve in RA and its association with clinical parameters such as disease activity, disease duration and seropositivity. A total of 13 studies met the eligibility criteria. Pooled data from 8 studies with random selection of RA patients revealed that 86 out of 1561 (5.5%) subjects had CTS. Subclinical CTS, on the other hand, had a pooled prevalence of 14.0% (30/215). The cross sectional area of the median nerve of the RA patients without CTS were similar to the healthy controls. The vast majority of the studies (8/13) disclosed no significant relationship between the median nerve findings and the clinical or laboratory parameters in RA. The link between RA and the median nerve abnormalities has been overemphasized throughout the literature. The prevalence of CTS in RA is similar to the general population without any correlation between the median nerve characteristics and the clinical parameters of RA.

Introduction

Systemic sclerosis (SSc) is an autoimmune disease which shows extreme heterogeneity in its clinical presentation and that follows a variable and unpredictable course. Although some discrepancies in the incidence and prevalence rates between geographical regions may reflect methodological differences in the definition and verification of cases, they may also reflect true local differences.

Objectives

To determine the prevalence and incidence of SSc in the city of Campo Grande, state capital of Mato Grosso do Sul (MS), Brazil, during the period from January to December 2014.

Methods

All health care services of the city of Campo Grande ‐ MS with attending in the specialty of Rheumatology were invited to participate in the study through a standardized form of clinical and socio‐demographic assessment. Physicians of any specialty could report a suspected case of SSc, but necessarily the definitive diagnosis should be established by a rheumatologist, in order to warrant the standardization of diagnostic criteria and exclusion of other diseases resembling SSc. At the end of the study, 15 rheumatologists reported that they attended patients with SSc and sent the completed forms containing epidemiological data of patients.

Results

The incidence rate of SSc in Campo Grande for the year 2014 was 11.9 per million inhabitants and the prevalence rate was 105.6 per million inhabitants. SSc patients were mostly women, white, with a mean age of 50.58 years, showing the limited form of the disease with a mean duration of the disease of 8.19 years. Regarding laboratory tests, 94.4% were positive for ANA, 41.6% for ACA and 19.1% for anti‐Scl70; anti‐RNA Polymerase III was performed in 37 patients, with 16.2% positive.

Conclusions

The city of Campo Grande, the state capital of MS, presented a lower incidence/prevalence of SSc in comparison with those numbers found in US studies and close to European studies’ data.